Autologous serum 50% eyedrops in the treatment of persistent corneal epithelial defects.

PURPOSE: To evaluate the success rate of treating persistent corneal epithelial defects using 50% autologous serum eyedrops.

METHODS: We reviewed the medical records of all patients seen at our institution from September 2004 to May 2007 who had persistent corneal epithelial defects that were nonresponsive to conventional medical treatment and that were treated with 50% autologous serum eyedrops. We also correlated the defect duration prior to initiation of serum therapy with rate of epithelial healing.

RESULTS: A total of 25 eyes of 25 patients failed conventional medical therapy for treatment of a persistent corneal epithelial defect and were treated with 50% autologous serum eyedrops every 2 hours while awake. All corneas were neurotrophic, with the etiologies being herpetic (11 eyes), postkeratoplasty (8 eyes), postkeratorefractive surgery (1 eyes), diabetic (1 eye), post-chemical burn (1 eye), and unknown (3 eyes). The median duration of the epithelial defects prior to initiation of autologous serum eyedrops was 13.9 weeks (range 0.29-52 weeks). After institution of autologous serum therapy, 23 of the 25 eyes healed in a mean time of 22.4 days. Seventeen eyes (68.0%) healed within 4 weeks (mean 1.7 weeks) of starting therapy with 50% autologous serum eyedrops. The number of days required for healing was associated with the length of time the defect was open prior to initiation of serum drops (r = 0.68, P < 0.001).

CONCLUSIONS: The use of 50% autologous serum eyedrops appears to be an efficacious medical treatment modality for persistent corneal epithelial defects that are recalcitrant to conventional medical therapy.